Robotic surgery in urology: a narrative review from the beginning to the single-site

Abstract

Abstract: Robotic surgery is a minimally invasive technique that is becoming increasingly popular in surgery and especially in urology. More and more major urological interventions, such as radical prostatectomy and partial nephrectomies, are evolving into laparoscopic and robotic minimally invasive techniques. Robotic surgery itself is constantly evolving in order to improve its performance and minimally invasiveness. A non-systematic literature review was performed using the PubMed/Medline electronic search engine using the following terms: “robotic surgery” or “development of robotic surgery” or “single site surgery” or “single port surgery”. Although it is a very recent technology, some preliminary experiences have been presented in the literature that document the feasibility of some major urological interventions, including radical prostatectomies, radical cystectomy, partial nephrectomy and ureterocystoneostomy. Long-term oncological and functional outcomes are not yet available and require more follow-up. Anyway, the single-port robotic system has proved feasible and safe, although in small cases series. Re-evaluating the development of robotic surgery, with each innovation, it aroused great enthusiasm, leading to a great diffusion of the method before having randomized clinical trials that confirmed the effective improvement of the technique compared to the gold standard. The urological community should not miss the second chance to be able to evaluate an emerging technique based on comparative clinical studies.